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Hunchback or Hunched back is a condition where there is exaggerated forward rounding of the upper back. Hunchback can occur at any age; however, it commonly affects older women, where this deformity is termed as a dowager's hump. Patients having osteoporosis develop age-related hunchback. There are some types of Hunchback which affect the infants or teens. Mild hunchback may not cause any problems, but severe hunchback can be very detrimental where it affects the lungs, nerves, tissues, and organs resulting in other medical problems. Treatment depends on age, cause and the effects of the Hunchback.

Causes and Risk Factors of Hunchback
Hunchback results when the vertebrae in the upper back become increasingly wedge-shaped and the cause for this can be various problems such as:

Disc degeneration.
Cancer and treatment for cancer.
Scheuermann's disease.
Congenital/birth defects.
Risk Factors: There are certain groups of people who are at increased risk of developing hunchback such as:

Adolescent girls who have a poor posture.
Boys aged between 10 and 15 are at increased risk of developing Scheuermann's kyphosis.
Older patients suffering from osteoporosis are at a higher risk for spinal fractures which can contribute to Hunchback.
Patients having connective tissue disorders (Marfan syndrome) are more prone to developing Hunchback.

Signs and Symptoms of Hunchback
The patient may not have any signs or symptoms if the Hunchback is mild.
Abnormally curved spine.
Stiffness in the back.
Pain in the back.
Investigations for Hunchback
Physical exam.
Neurological exam to check reflexes and muscle strength.
X-rays to determine the degree of curvature and to detect deformities of the vertebrae.
Computerized tomography (CT scan) for more detailed images.
Magnetic resonance imaging (MRI) to rule out tumor or infection.
Nerve tests are done if the patient is experiencing any muscle weakness or numbness to check the nerve impulses.
Lung function tests are done for a severe hunchback to check if the curve is affecting the patient's ability to breathe.
Treatment for Hunchback
Treatment depends on the cause of the condition and the symptoms of the patient.

OTC pain relievers such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin) or naproxen (Aleve) can be given. If these are not effective then stronger pain medications are prescribed by the doctor.
If the patient has osteoporosis, then drugs for osteoporosis such as bone-strengthening drugs are given to prevent fractures of the spine which may worsen the hunchback. In many patients, Hunchback is the first indication that they have osteoporosis.
Other Therapies Which Are Beneficial for Hunchback Are
Exercises such as stretching exercises help in improving the flexibility of the spine. Exercises which help in strengthening the abdominal muscles also help in improving the posture.
Bracing can also be used especially in children suffering from Scheuermann's disease to help halt the progression of hunchback. These children can wear a body brace to prevent the hunchback from getting worse while their bones are still growing.
Surgical procedures are done if the curvature of the spine is exaggerated such as seen in severe hunchback and especially if it is pinching the spinal cord or the nerve roots. Surgery helps in reducing the degree of the hunchback curvature. The most common procedure done is called spinal fusion where two or more of the affected vertebrae are permanently connected. The complications for spinal surgery are quite high and include Infection, bleeding, pain, arthritis, nerve damage, and degeneration of the disc. A second surgery may be required if the initial surgery has failed to rectify the problem.

Good Posture for Hunchback: How to Fix Your Posture

Good posture is very essential to maintain a healthy mind and body. It helps in aligning the spine with itself. Having a good posture also helps in alleviating common problems like back or neck pain, headaches, and fatigue. Other than improving your health, a good posture also boosts your self-confidence and your carriage. The steps to develop a good posture are:

Identifying a good posture: The first step is identifying a good posture i.e., a straight back, squared shoulders, chin up, chest out, stomach in. In a good posture, you should be able to draw a straight line from your earlobe through your shoulder, hip, knee, to the middle of your ankle. With the help of a mirror, align your ears, shoulders, and hips. These points should make a straight line; however, spine curves naturally in a slight 'S' shape. If you are experiencing pain, then look at your side view to see if you're forcing your spine into an unnatural position. The two natural curves in the spine need to be maintained. These are known as the 'double C' or 'S' curves and are found from the base of the head to the shoulders and the curve from the upper back to the base of the spine. Make sure that your weight is evenly distributed on your feet when standing upright.
Training or exercising your muscles: The next step in improving your posture is to do exercises which will help in strengthening the muscles across the upper back and shoulders so that you naturally and unconsciously maintain a correct posture all the times without feeling any fatigue.
Pretend to be a penguin by placing your elbows at your sides and touching your shoulders with your hands. Keep your hands on your shoulders with your ears aligned. Raise both the elbows and lower them back again.
Practicing yoga is extremely beneficial in developing a good posture. Yoga also helps in improving balance; strengthening the core muscles and helping you maintain proper body alignment.

Dr. Shweta Muley
Dr. Shweta Muley
BHMS, Homeopath, 6 yrs, Pune
Dr. Dr.Sandip Narkhede
Dr. Dr.Sandip Narkhede
MS/MD - Ayurveda, Infertility Specialist Lactation Consultant, 10 yrs, Pune
Dr. Gopal Samdani
Dr. Gopal Samdani
MBBS, Pediatrician, 30 yrs, Pune
Dr. Mayur Ingale
Dr. Mayur Ingale
MBBS, ENT Specialist, 4 yrs, Pune
Dr. Pawan Sarda
Dr. Pawan Sarda
BAMS, Family Physician, 10 yrs, Pune